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of the adjoining senior schools. Pupils attending five classes in four
other schools who might have been contacts of cases or carriers
were also swabbed. Bacteriological investigation of the mass swabbings
was carried out by the London County Hall, Public Health
Laboratory, and of approximately 3,000 swabs submitted only two
carriers were discovered who could not be considered to be closely
associated with any of the known cases or carriers. This small
number found in what might be regarded as the general community of
school children supports the supposition that it is rare nowadays
to find carriers except amongst persons closely associated with an
outbreak.
The bacteriology associated with the close school and community
contacts was carried out by the Laboratory attached to the
local isolation hospital where, with the exception of case 1 and II,
who had been treated at home with antibiotics for several days prior
to admission to hospital, and case XI, who also received antibiotic
therapy and was only considered to be a case when the complication
of palatal paralysis was discovered several weeks later, all the cases
and carriers detected were found to be infected with a virulent gravis
strain C. diphtheriae.
In all some 4,000 swabs from 1,800 persons were submitted
for examination, and a vast amount of work was carried out by the
medical, nursing and administrative staffs in following up contacts
and keeping them under observation.
Previous Immunisation History.
One of the patients, aged 13 years (Case VI) had had a full
course of immunisation in 1946, with a booster dose in 1950, and his
brother aged 10 years (Case VII) completed immunisation in 1950
and had a booster injection in 1954. In both cases the illness was so
slight that there was some doubt regarding the diagnosis. Two other
children had begun a course of primary immunisation 5 and 7 years
previously and had not completed it. No immunisation record cards
could be found for the remaining seven cases including the original
two cases. Nine of the carriers including 2 sisters of cases VI and
VII had been immunised at some time. Three others, carriers who
had never been immunised, had been protected by prophylactic serim.
Three adult carriers were detected.
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